PMT17-02209 City of Menifee Permit No.: PMT17-02209
29714 HAUN RD. T Residential Mechanical
'�1 /->CCEL MENIFEE,CA 92586 yam'
MENIFEE Date Issued: 06t28/2017
PERMIT
Site Address: 28754 VELA DR, MENIFEE, CA 92586 Parcel Number: 339-480-007
Construction Cost: $1,200.00
Existing Use: Proposed Use:
Description of FURNACE CHANGE OUT ONLY, 90,000 BTU(CLOSET)
Work:
Owner Contractor
PATRICIA HOFERER W C HEATING&AIR CONDITIONING INC
28754 VELA DRIVE 41085 GOLDEN GATE CIR
MENIFEE, CA 92586 MURRIETA, CA 92562
Applicant Phone:9516000700
JILL WESTON License Number: 779504
WC HEATING&AIR CONDITIONING INC
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description Ply Amount 1$1
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Building Permit Issuance 1 27.D0
GREEN FEE 1 1.00
General Plan Maintenance Fee-Mechanical 1 7.45
$184.45
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for cohstmction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg_Permit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that 1 am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exempt from Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class Can License No. —)--)ak4(-'( By my signature below I acknowledge that,except for my personal residence
Expires Signature W1301 av`-� in which I must have resided for at least one year prior to completion of
�17- improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.html.
this permit is issued.
Polity# Date
ave and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
s ction 3700 of the Labor Code,for the performance of the work for which O By my signature below l certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number am:y� �."`��c application and the information I have provided is correct.I agree to comply
Carrier [�L:.KL�fl�YCJ "aA-Xa ' with all applicable city and county ordinances and state laws relating to
�`,��`�� building construction.I authorize representatives of this city or county to
Policy#W Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued, /� /� (�
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 6551Q0 et..
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,1 shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant 19.1- �J.e✓� Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FA RE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑yes t?No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY ❑Yes V'No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet ofthe
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) O Yes 9No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe State of
I hereby affirm under penalty of perjury that 1 am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Oyes Ao, `_ ,,�
Business and Professions Code).Any city or county that requires a permit to WD/3Cb`� Date
construct,alter,improve,demolish or repair any structure,prior to its PROPER WNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exemptfrom Iicensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.goy/lead or contact the National Lead Information Center at
not intended or offered forsale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement Is sold within one year of Firm Certifrmtion No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or Improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project bemuse:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please full out the RRP
Acknowledgement
-�Ydhy ' 1/'li`Ji7aL7tl-YlN1Ui:Ii Ijo !
Menifee
DATE 0 612 712 01 7 PERMIT/PLAN CHECK NUMBER
TYPE: []COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑✓ MECHANICAL
❑NEW []PLUMBING ❑RE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK FURNACE CHANGE OUT ONLY.90K BTU FURNACE(CLOSET)
PROJECT ADDRESS 28754 VELA DR,MENIFEE
ASSESSOR'S PARCEL NUMBER LOT TRACT
PROPERTY OWNER'S NAME PATRICIA HOFERER
City of Menifee
ADDRESS 28754 VELA DR,MENIFEE Buildin
PHONE (760)803-6930 EMAIL
APPLICANT NAME SILL WESTON 1 WE GREEN
ADDRESS 3645 RUFFIN RD.9330 SAN DIEGO CA 92123 R
PHONE (949)630-1550 _ EI17:i1:
CONTRACTOR'S NAME RUSSELL COCHRAN — OWNER BUILDER? E]YESj2NO
BUSINESS NAME WE CARE
ADDRESS 41805 GOLDEN GATE CIRCLE,MURRIETACA
PHONE (951)600-7000 EMAIL
CONTRACTOR'S STATE LIC NUMBER
779604 LICENSE CLASSIFICATION C20
VALUATION$ $1,200-00 SO FT L SO FT
APPLICANTS SIGNATURE DATE
1 ,
.,.,. '_ t,��'.: ' `� .0�i 1�i t�e� � :if " � � 5 r✓L"^`�, _ .r'T•'-e\,�XM�k- �
_•JJ J ' �T "'' CITY OF MENIFEE BUSINESS LICENSE NUMBER
DEPARTMENT 0151RIBU I JUN
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE ,� 1 PAIDAMOUNT 14 1 XT O CASH 0 CHECK 0 OCREDITCARD WWMIC
AMOUNT V`—i. � LJ'�
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK R O CREDIT CARD VISVMC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building 9 Safely Department 29714 Houn Rd. Menifee, CA 915S6 951-672-6777
www.cayofineni(ee.us Inspection Request Line 951-146-6213
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